MEDICARE: CHRISTINA KOSMIDIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA8300	MA

General Provider Information

NPI Number	:	1073170460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA KOSMIDIS

Provider Business Mailing Address
First Line	:	26 FOREST PARK
Second Line	:
City	:	FITCHBURG
State	:	MA
Zip	:	01420-5320
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 MASONIC CIR
Second Line	:
City	:	AUBURN
State	:	MA
Zip	:	01501-1341
Country	:	US
Telephone Number	:	978-602-2096
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2019
Last Update Date	:	04/09/2025

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Directions to “ CHRISTINA KOSMIDIS ” Practice Location

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